NPI | 1437513744 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA MD467473) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207R00000X Internal Medicine (Licence: SC 87520) | |
Enumeration Date | 2016-04-12 |
Last Update Date | 2022-09-30 |